Provider Demographics
NPI:1043363948
Name:BISCHOFF, ROBERT SAMUEL (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SAMUEL
Last Name:BISCHOFF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 HOOPER AVE
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-7719
Mailing Address - Country:US
Mailing Address - Phone:732-349-1122
Mailing Address - Fax:732-349-1116
Practice Address - Street 1:800 HOOPER AVE
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7719
Practice Address - Country:US
Practice Address - Phone:732-349-1122
Practice Address - Fax:732-349-1116
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00513900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU95934Medicare UPIN
NJBI008960Medicare ID - Type Unspecified